AB0535 LEPTIN LEVELS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS, CONNECTION WITH COURSE OF THE DISEASE AND ATHEROSCLEROTIC VASCULAR LESIONS
Authors: O. Shkilna, S. Shevchuk
Journal: Annals of the Rheumatic Diseases (2022)

Background Atherosclerosis and its complications remain the leading causes of death in patients with systemic lupus erythematosus (SLE). Along with the known pathological factors that significantly accelerate the development of cardiovascular events in patients with SLE (hyperinsulinemia, hypertension, atherogenic dyslipidemia, disease activity, etc.), in recent years the role of dysadipokinemia has been intensively studied. In patients with SLE serum leptin increases, but how its concentration changes under the conditions of the inflammatory process and how it is associated with other factors that aggravate the course, have not been studied enough. Its role in the formation of atherosclerotic vascular lesions in patients with SLE is also unknown. Objectives The aim of the study was to assess leptin levels in patients with SLE and to analyze its relationship with the course of the disease, lipid spectrum and atherosclerotic vascular lesions. Methods We examined 45 patients with SLE (31 women and 4 men), mean age - 46.23 ± 1.36 years). The average duration of the disease was 9.97 ± 0.82 years. SLE was verified on the basis of ACR / EULAR criteria (2019) and formulated according to the classification recommended by the Association of Rheumatologists of Ukraine (2020). The control group included 20 healthy individuals of the appropriate age and sex. The content of leptin in the serum was determined by enzyme-linked immunoassay according to the instructions of the manufacturer. The SLEDAI index was used to assess activity. Assessment of endothelial function was determined by the Celermajer method. Results The level of leptin in the serum in apparently healthy individuals and patients with SLE differed significantly. In particular, the average hormone content in patients with SLE was 39.4 ± 3.4 ng / ml, while in the control group - 24.4 ± 3.8 ng / ml, ie it was higher by 38.1% (P &lt;0.01). The patient’s age and disease duration were weakly related to leptin levels (r = 0.25, r = 0.34, respectively). It was found out that in patients with SLE serum leptin levels were directly proportional to the disease activity. In particular, a close associative relationship was established between the activity of the disease determined by the SLEDAI index and ESR (r = 0.81, r = 0.42, respectively). The study found a close association between serum leptin concentrations and blood lipid spectrum in patients with SLE. In particular, it was the highest with LDL(low density lipoprotein) (r = 0.54), and probable with total cholesterol and triglycerides (r = 0.32, r = 0.28, respectively). In patients with SLE with a high (≥42.2 ng / ml) leptin level, the endothelium-dependent vasodilation brachial artery (EDV BA) was 52.3% higher and the CCA IMT (common carotid artery intima-media thickness) was 32% higher than in patients with relatively normal leptin levels. In addition, the proportion of patients with a decrease in EDV BA and a thickening of CCA IMT among patients with high leptin levels was 12–25% higher than among patients with relatively normal levels of the enzyme under study. The presence of atherosclerotic plaques, their area and the severity of atherosclerotic lesions of the carotid arteries also determined the tendency to increase in proportion to the increase in serum leptin levels. Thus, hyperleptinemia in patients with SLE is associated with deterioration of vascular function of the carotid artery and the severity of atherosclerotic vascular lesions. Conclusion Significantly higher levels of serum leptin were found in patients with SLE, which were associated with inflammatory activity and dyslipidemia, as well as with structural and functional reorganization of blood vessels, which should be considered as an important risk factor for vascular lesions. Disclosure of Interests None declared